Eastern Mediterranean Health Journal最新文献

Background: Adherence to infection prevention and control (IPC) guidelines is mandatory in healthcare service provision.

Aims: We assessed the knowledge and adherence to IPC guidelines among dentists in the West Bank and Jerusalem.

Methods: A self-administered questionnaire was distributed to a convenience sample of dentists in the West Bank and Jerusalem between 12 March 2019 and 9 May 2019. The total sample comprised 395 dentists, categorized into good compliance and fair compliance according to a scale developed from 32 questions. The Chi-squared test was used to compare the 2 categories. Data were analysed using SPSS, version 25.

Results: Overall compliance with IPC guidelines was low; only 18.5% of respondents reported good compliance. Compliance with basic principles such as wearing gloves and changing them for each patient and using autoclaves to sterilize equipment was high. Good compliance was significantly associated with age, years of experience, and year of graduation, P = 0.045, P = 0.036 and P = 0.007, respectively. Providers in the north of West Bank and public sector workers were significantly associated with good compliance, P = 0.018 and P ≤ 0.0001, respectively. Experiencing a needle stick injury and the number of needle stick injuries experienced were significantly inversely associated with good compliance, P ≤ 0.001.

Conclusion: Based on our results, there is a need for substantial improvements in compliance with IPC guidelines by dentists in the West Bank and Jerusalem; mandatory education and training regulated by governing institutions would be very helpful.

Background: Bedbug infestation has been reported globally, but there are few reports about this parasite of public health importance in Pakistan. This is the first study on bedbug infestation in a healthcare setting in Lahore, Pakistan.

Aims: To study bedbug infestation in public sector hospitals in Lahore, Pakistan.

Methods: This cross-sectional study was conducted in 86 wards of 2 tertiary care hospitals in Lahore during October and November 2019, using nonprobability sampling technique. Ward supervisors were interviewed using a self-developed structured questionnaire and wards were examined for bedbugs or their markers.

Results: Evidence of bedbug infestation was found in 72.1% of the wards. There was no significant difference in infestation rate between the 2 hospitals but there was a significantly lower incidence of infestation in wards that implemented control measures (25.8% vs 74.2%). No control measures were implemented in 53.4% of the wards sampled.

Conclusion: Bedbug infestation was rife in the 2 hospitals studied and knowledge about identification and eradication of the pest among ward supervisors was inadequate. Control measures, where applied, were substandard and not evidence-based.

Over the years, the Eastern Mediterranean Region (EMR) has faced a funding gap with respect to malaria, tuberculosis (TB), HIV, and vaccine-preventable diseases programmes. In the early 2000s, Gavi, the Vaccine Alliance (Gavi) and the Global Fund against AIDS, TB and Malaria (GFATM) became important financial contributors to these programmes. In 2000-2015, funding support from these two global health initiatives allowed progress. However, from 2015, coverage of interventions plateaued, and the region is now behind on the related Sustainable Development Goal (SDG) targets.

Background: Data are scarce on differences in the rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection after the first infection.

Aims: We examined nationwide data on SARS-CoV-2 reinfection in Kuwait according to four-time windows to reinfection: 29-45 days, 46-60 days, 61-90 days, and ≥ 91 days.

Methods: This was a population-level retrospective cohort study conducted between 31 March 2020 and 31 March 2021. We reviewed evidence of second positive RT-PCR test results for those who had previously recovered from COVID-19 and tested negative.

Results: Reinfection rates were: 0.52% for reinfection window 29-45 days, 0.36% for 45-60 days, 0.29% for 61-90 days, and 0.20% for ≥ 91 days. The mean age (standard deviation [SD]) of individuals with the shortest reinfection time interval (29-45 days) was significantly older than the mean age of all other groups - 43.3 years (SD 17.5) compared with: 39.0 years (SD 16.5), P = 0.037 for 46-60-day interval; 38.3 years (SD 16.5), P = 0.002 for 61-90-day interval; and 39.2 years (SD 14.4), P = 0.001 for ≥ 91-days interval.

Conclusion: SARS-CoV-2 reinfection was uncommon among this adult population. Older age was associated with a shorter time to reinfection.

Background: The Afghanistan Reconstruction Trust Fund, managed by the World Bank through a contracted-out instrument called Sehatmandi, financed health service delivery in Afghanistan, with substantial achievements in infant, child and maternal health. After the collapse of the Afghan Government on 15 August 2021, the health system has been on the brink of collapse.

Aims: We assessed the use of basic health services and estimated excess mortality resulting from the interruption to healthcare funding.

Methods: We conducted a cross-sectional study that compared health services utilization from June to September for 3 consecutive years, 2019, 2020 and 2021, using 11 output indicators reported by the health management and information system. We used the Lives Saved Tool, a linear mathematical model with input data from the Afghanistan Demographic Health Survey 2015, to calculate the additional maternal, neonatal and child mortality at 25%, 50%, 75% and 95% reduction in health coverage.

Results: During August and September 2021, after the announced ban on financing, health service utilization decreased to a range of 7-59%. Family planning, major surgeries and postnatal care showed the greatest decreases. Uptake of child immunization showed one-third decrease. Sehatmandi provides around 75% of primary and secondary health services: pausing funds to this programme will result in additional 2862 maternal deaths, 15 741 neonatal deaths, 30 519 child deaths, and 4057 stillbirths.

Conclusion: Sustaining the current level of health services delivery is crucial to avoid excess, preventable morbidity and mortality in Afghanistan.

Background: Reliable estimation of prevalence is important for monitoring and evaluation of COVID-19 prevention programmes among at-risk populations.

Aims: We compared the capture-recapture method with a seroprevalence survey for accurate estimation of the prevalence of COVID-19 during a 1-year period in Guilan Province, northern Islamic Republic of Iran.

Methods: We used the capture-recapture method to estimate the prevalence of COVID-19. Records from the primary care registry system and the Medical Care Monitoring Center were compared, using 4 matching approaches based on combinations of the following variables: name, age, gender, date of death, positive or negative cases, and alive or dead cases.

Results: The estimated prevalence of COVID-19 in the study population from the beginning of the pandemic in February 2020 until the end of January 2021 was 16.2-19.8%, depending on the matching approach used, which was lower than in previous studies.

Conclusion: The capture-recapture method may provide better accuracy than seroprevalence surveys in measuring the prevalence of COVID-19. This method may also reduce the bias in the estimation of prevalence and correct the misconception of policymakers about seroprevalence survey results.

Background: General and central obesity are important risk factors for chronic diseases and health-related outcomes.

Aims: We determined the prevalence of obesity and related complications among individuals aged 40-70 years in Kherameh, southern Islamic Republic of Iran.

Methods: This cross-sectional study included 10 663 people aged 40-70 years who participated in the first phase of the Kherameh cohort study. Data were collected on demographic characteristics, history of chronic diseases, family history of diseases, and various clinical measures. We used multiple logistic regression analysis to establish the relationships between general and central obesity, and related complications.

Results: Of the 10 663 participants, 17.9% had general obesity and 73.5% had central obesity. In people with general obesity, the odds of having the non-alcoholic fatty liver disease and cardiovascular disease were 3.10 times and 1.27 times higher than in individuals with normal weight, respectively. People with central obesity had higher odds of having other components of metabolic syndrome such as hypertension (OR: 2.87; 95% CI: 2.53-3.26), high triglyceride levels (OR: 1.71; 95% CI: 1.54-1.89), and low high-density lipoprotein cholesterol levels (OR: 1.53; 95% CI: 1.37-1.71) than those without central obesity.

Conclusions: The study showed a high prevalence of general and central obesity and health-related effects, and its association with several comorbidities. Given the level of obesity-related complications found, primary and secondary prevention interventions are needed. The results may help health policymakers establish effective interventions to control obesity and related complications.

Background: Antibody testing can complement molecular assays for detecting COVID-19.

Aims: We evaluated the concurrence between lateral flow assay and enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).

Methods: The study was conducted at Kocaeli University, Türkiye. We used a lateral flow assay and ELISA to test serum samples from COVID-19 cases, confirmed by polymerase chain reaction assays (study group) and pre-pandemic stored serum samples (control group). We used Deming regression to evaluate the antibody measurements.

Results: The study group included 100 COVID-19 cases, and the control group included pre-pandemic samples from 156 individuals. The lateral flow assay detected immunoglobulin M (IgM) and G (IgG) antibodies in 35 and 37 study group samples. ELISA detected IgM nucleocapsid (N) antibodies in 18 samples, and IgG (N) and IgG spike 1 (S1) antibodies in 31 and 29 samples, respectively. None of the techniques detected antibodies in the control samples. Strong correlations were found between lateral flow IgG (N+ receptor-binding domain + S1) and ELISA IgG (S) (r = 0.93, P < 0.01) and ELISA IgG (N) (r = 0.81, P < 0.01). Weaker correlations were seen between ELISA IgG S and IgG N (r = 0.79, P < 0.01) and lateral flow assay and ELISA IgM (N) (r = 0.70, P < 0.01).

Conclusion: Lateral flow assay and ELISA techniques gave consistent results for IgG/IgM antibody measurements towards spike and nucleocapsid proteins, suggesting that both methods can be used to detect COVID-19 where access to molecular test kits is difficult.

Background: Water-borne parasitic infections are caused by pathogenic parasites found in water. These parasites are often not well-monitored or reported, therefore, there is an underestimation of their prevalence.

Aims: We systemically reviewed the prevalence and epidemiology of water-borne diseases in the Middle East and North Africa (MENA) Region, which has a population of about 490 million people distributed over 20 independent countries.

Methods: Online scientific databases, mainly PubMed, ScienceDirect, Scopus, Google Scholar, and MEDLINE were searched for the main water-borne parasitic infections in MENA countries during 1990-2021.

Results: The main parasitic infections were cryptosporidiosis, amoebiasis, giardiasis, schistosomiasis, and toxocariasis. Cryptosporidiosis was the most frequently reported. Most of the published data were from Egypt, the country with the highest population in MENA.

Conclusions: Water-borne parasites are still endemic in many MENA countries, however, their incidence has reduced dramatically due to the control and eradication programmes in countries that could afford such programmes, some with external support and funding.